NPI | 1467482414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME118532) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 234549) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2016-12-15 |